HomeMy WebLinkAbout74802D - Gammonsf
4AMA / -i \DREDGE,& FI�L
NO, 74802 C D
-� NERAL PERMIT
A B
Previous permit#
ew Modification -]Complete Reissue
CPartial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name
Project Location:
County
Address �-
Street address/ State Road/ Lo/t�#(s)
City 1
teZIP
Phone # ( -Mail
Subdi ' ion
Authorized Agent " /�(� ���
City
ZIP
U
Affected ❑ CW L EW ❑ PTA ❑ ES ❑ PTS
Phone # ( )
Rivec Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
V l nat an unkn
❑ PWS:
ORW: yes no PNA yes / no
Closest Maj. Wtr.
Body
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Age or OpTicantName
�Printed
Si nature * Please read compliance statement on back of�ermit
Application Fee(s)
Check #
AGENT AUT11 R t=OR CAMA PERMIT APPL C—AT IQN
Name of Property Owner Requesting Parmo-rimj?3tNIIi1II,i__ -
Mailing Addresg
Phone Number,
Email Address:
I Certify that I have authorized
144 Foothill Farm Lane
Pilot Mountain NC 27041
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to act on my behalf, 1cx ttw purpege of applying for and obtaining all CAMA permits
necessary for the following proposed development bulkhead 811Z!_fift"M]W
at my property located at 109 Southwest 25 street, Oak Island N C
in jr„nSWxj County
1 furthormom certify that I am "uthofizod to grant. and do in fact grant percussion to Division of Co@stat Management stag tho Local POmW Oficer and their agents to entor
on the aforementioned lends in connection permit appticotrot; with eve►uet rg information retetecJ to this
Property Owner informat*n
Tim Gammons
Wlnt or Typo Nemo
rft
10 I1_r 2019
Oahe
This certification ix valid through 1 r
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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Prnoerty O%vrtet Tim Gammons
Address of Proeerty
109 Southwest 25 street, Oak Island N,C
;t of or Street d Street or Road. City b County)
Agent's Name *: �GI. C Mailing Address 101 N - ft'�'%'dV. &'—
Agent's phone __.7 0 44 31 1 d.
I hereby certity that I own property adjacent to the above referenced property The individual
applying toow
s permit has described to me as shn on the attached dravmg the development
7171'havc
posingA description or drawing. with dimensions" mu 17e pMv►ded with this "or no objections to this prcpo%al. _ _ I hRvc objections to this pmpocal
1 you have objections to *fiat is being proposed, you must notify (he Division of Coastol Manaywnent IDCM) in
#ruing w,thrn 10 days of receipt of this notice Correspondence should be mailed to 127 Cardinal Drive EA t .
NNmmgton, NC 28405.3845. DCM representatives ran also be contacMd at (910) 796-7215. No response (s
_onsidered the same as no objec(ion if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a D►er, dock mooring pil ngs, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15from my area of riparian access unless waived by me {If you
wish to waive the setback, you r_tltlst initial the appropriate blank below)
I do wish to waive the 15' setback requiremen!
do not wish to waive the 15' setback requirement
(Property Owner Information) A aCant Prop Owner lotormationt
/she.�te.ra-
��(,1�►llll--
Tim Gammons J!
rrww or Type Name Puri( or Ty,p(g Name
144 Foothill Farm Lane
Mailing Address
Pilot Mountain NC 27041
C(tylSlate2p
=:429 6036
fe/bpbone Number
10/ 16/2019
/-71 Ao/L�
MaOng Address
0tyy/54a#&Zp
Telephone Number
Remsed &IW012
N.
Doi it S Care, I
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10 -tom+ a,-% cae K s;�
Date Received
Date Dewsited Crock Ftom Name
Name of Permit Holder _
Co.Columns
Vendor _
1 First Citizens Bank
Check Number
Check
amount Permit Number/Comments _
Colum , Column8 _ _
400.00 GP 74802D
Recel t or RelundlReaADcated
Column?
Column Column
Column6
Column9
11/27/2019, 11/27/2019 McPherson Marine Services LLC Tim Gammo ns
2153'
_
Tmac rct. 9498D